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Bone and Joint Tex4

Bone and Joint Tex4 - • Presence of foreign materials(PMN...

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Bone and Joint Text Hematogenous spread an infection at another site disseminates to the blood (bacteremia), which then carries the bacteria to the site in the bone Location is age dependent: children - distal femur and proximal tibia are favored sites o Case 2: 12 year old girl with 18 months of ankle pain but no fever or chills. Eventually a radiograph was done that demonstrated a Brodie's abscess – a chronic localized bone abscess, usually found in the distal tibia. adults - most common sites – vertebrae, sternoclavicular joint, sacroiliac joint, symphysis pubis Contiguous spread Implies an initial infection that by continuity gains access to bone In association with vascular insufficiency Associated with poor wound healing and chronic ulcers Seen in diabetics or others with peripheral vascular disease Most often affects lower extremities 3. Who gets Osteomyelitis? 3.1. Risk Factors:
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Unformatted text preview: • Presence of foreign materials (PMN defect, adhesion of microorganisms) • Diabetes (microvascular disease, poor wound healing, neuropathy) • Surgery • Adjacent soft tissue infection • Peripheral vascular disease • Sickle cell disease (devitalized bone) • Congenital defects in phagocyte function 4.1. History and physical examination 1. presence of risk factors 2. fever, local pain and tenderness, swelling, decreased range of motion of a joint, erythema, warmth, drainage, sinus tracts, ulceration 4.2. Radiographic diagnosis 1. Routine radiographs ("plain films") o fairly specific but appearance of abnormalities might be delayed (up to 15 days after symptoms appear) o Cortical destruction with periosteal new bone formation Ex. 1. Salmonella osteomyelitis of the tibia, began in shaft. See cortical destruction, new bone formation and fissure in cortical bone...
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Bone and Joint Tex4 - • Presence of foreign materials(PMN...

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